<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">体检项目:</label>
        <div class="col-xs-12 col-sm-8">
            {$row.item_price_info}
            <input type="hidden" class="sp_hidden" name="row[item_id]" id="c-item_id" value="{$row.item_id|htmlentities}" data-rule="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">项目类型:</label>
        <div class="col-xs-12 col-sm-8">
            <select  id="c-item_type" data-rule="required" class="form-control selectpicker"  name="row[item_type]">
                {foreach name="item_types" item="vo"}
                    <option value="{$vo.id}" {in name="vo.selected" value="1"}selected{/in}>{$vo.name}</option>
                {/foreach}
            </select>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">优惠扣减:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-item_discount" data-rule="required" class="form-control" name="row[item_discount]" type="text" value="{$row.item_discount|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
